Individual provider Active NPI

Stephanie Lynn Morales, PA-C

  • Physician Assistant
  • Colton, CA
National Provider Identifier
1063582435
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA18579 Issued in CA
Practice address
400 N Pepper Ave.
Colton, CA 92324
Phone
(909) 580-1400
NPI assigned
Nov 9, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA18579 CA Primary

Addresses

Primary practice location

400 N Pepper Ave.
Colton, CA 92324

Mailing address

325 San Dimas Canyon Rd. #145
San Dimas, CA 91773
Phone (805) 300-0402

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA18579CAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Department of Health CurrentSince Jul 15, 2021 Accepting new patients
Cep America-California CurrentSince Oct 15, 2006 Accepting new patients
Florida Department of Health CurrentSince Jul 15, 2021 Accepting new patients
Cep America - California CurrentSince Oct 15, 2006 Accepting new patients
Cep America - California Past Accepting new patients

Locations

2755 Herndon Ave
Clovis, CA 93611
Phone (559) 323-4000

400 N Pepper Ave
Colton, CA 92324
Phone (909) 580-1400

2100 Powell St
Ste 900
Emeryville, CA 94608
Phone (510) 350-2777

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

362 State Highway 83
Defuniak Springs, FL 32433
Phone (850) 892-8015

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1163030400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1063582435",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "325 SAN DIMAS CANYON RD. #145",
            "city": "SAN DIMAS",
            "state": "CA",
            "postal_code": "91773",
            "telephone_number": "805-300-0402"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 N PEPPER AVE.",
            "city": "COLTON",
            "state": "CA",
            "postal_code": "92324",
            "telephone_number": "909-580-1400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORALES",
        "first_name": "STEPHANIE",
        "middle_name": "LYNN",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-09",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA18579",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Colton, CA

Sources for this page

Verify at the official NPI Registry.